The weird part of hh

  1. 2 At least half, if not 75% of my patients tend to be angry about having to have home health. Because I do so many OASIS admits and recerts I end up spending a lot of time in surly people's homes. I realize that they are ill, hurting, scared, aging, demented, worried about cost, but now 4 weeks into it is really starting to be strange to me. Even after I explain that Medicare covers the cost entirely they make me feel like I am doing a gynecological exam or something.
    Yesterday I had to admit a 80 yr old lady who had had a total hip. She sat with a strange demented smirk and stared past me, not answering my questions. I am very friendly, caring, warm, don't rush into the bowel movement questions, but her husband acted like he was under attack again in Normandy. "Do you have pain?" no answer, stare into space, turn to husband after about 15 questions go unanswered and ask quietly "Is she ever confused?" He turns and yells "AREN'T WE ALL???" Whatever, get in my car and go.
    Next lady, another hip, I do all of my explaining. She just kept harping at me "This wasn't how it was when I had my other hip done" She wanted me to set up a strict schedule of visits because "I am very active and am not home a lot" Oh Lord, then I had to explain home-bound status. She was furious, assuring me that back 2005 no such thing existed.
    I could go on and on. I'm not the kind of person who rushes in, demanding attention and ordering them around, but this is just weird.

    One more thing: Have you guys noticed that most patients don't turn the tv off (or even down) when you're there? I swear, everyone watches Judge Judy and has their curtains shut, probably so the smoke won't go out!
    Needless to say, I LOVE this job!
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  3. Visit  nurseby07} profile page

    About nurseby07

    43 Years Old; Joined May '05; Posts: 348; Likes: 318.

    15 Comments so far...

  4. Visit  caliotter3} profile page
    1
    Sure sounds weird to me, especially since such a large percentage of your clients seems to act this way. Hope they come around after awhile.
    nurseby07 likes this.
  5. Visit  barefootlady} profile page
    1
    It may sound strange to some but I have been exactly where you are and know beyond a shadow of a doubt some of the patients really resent you being there, asking questions, giving tips, explaining issues. I had one fellow tell me, "I don't give a damn, just leave." Another old lady wanted her son to tell me everything, she was so busy watching Judge Judy. LOL! HH is another world, and when it is the rural world it is very different. Good luck.
    nurseby07 likes this.
  6. Visit  homehealth43130} profile page
    3
    It use to be Bob Barker - you didn't dare show up during The Price is Right or you might not get in the door. :chuckle
    HmarieD, Marshall1, and nurseby07 like this.
  7. Visit  GrumpyRN63} profile page
    0
    Quote from homehealth43130
    It use to be Bob Barker - you didn't dare show up during The Price is Right or you might not get in the door. :chuckle
  8. Visit  RN1263} profile page
    2
    I've been doing home health for 4 mos. and it's really been a roller coaster ride trying to figure out what clients want or expect from me.....
    Yes, 60% act as if I "demanded" to come into their homes, ask personal questions and "waste" their time....Totally ridiculous!!!

    Don't get me wrong there are alot of plus's to home health and that's why I'm still doing it, but I wish the patients understood we are their advocates and are trying to help them NOT be a nuisence to their lives. If I see something that isn't right I call the doctor- Only to be told later by the pt that I should've minded my own business, because now they have to take a medication they can't afford, ect...I could go on and on w/ these examples!.....So, end result they get mad at me for advocating for them and sometimes even request that I don't come back......Sometime I think I care too much and that I get too involved w/ each patients case BUT isn't that are job
    nursynurseRN and nurseby07 like this.
  9. Visit  annaedRN} profile page
    4
    I live in a fairly rural area, and I do occasionally get the patient that seems like I am intruding, but the majority really appreciate that I am there and really listen to what I say. We have a VNA nurse that is a FT hospital liason and she is able to "prep" alot of our patients on our services and how we will be helping them. There is a few other hospitals that we get patients from, but the main one is "covered".

    I have a bigger problem with hospital nurses or social workers promising patients "the vising nurses will be out every day to change your wound or empty your colostomy..." I think that hospital staff in general would benefit from an inservice in WHAT we do...which is teach/provide services to allow patients to be independent at home...and while there are a few exceptions that patients need daily visits - usually the we teach the patient/family to provide their own care! It is hard to sometimes undo the uninformed promises made by the hospital personnel. Sorry for the rant!
    HmarieD, NurseCurtis, caliotter3, and 1 other like this.
  10. Visit  NurseRoRo} profile page
    0
    I have to say I have an opposite problem in my HH job. My patients LOVE for a nurse and a HHA to come visit and most are disappointed when I say we are INTERMITTENT nursing and are not 24 hours in home care!

    Homebound is an ongoing issue...don't get me started on "I've got a doctor's appt on Tuesday, and after that I'm going out to the Elks club to play poker till it's supper time and we all go to Cracker Barrel."

    The patients do not enjoy my 1+ hour stay when I do admissions but then they can't wait to know exactly when I'm coming back and why I can't come everyday. Oh, and this past week a family was floored when I was about to anchor a foley cath and explained to them how to open the spout to drain the bag. They were under the impression that they would call me to come out and empty the bag...EVERY TIME.

    Sheeesh, can't make everyone happy, ya know?
    Last edit by NurseRoRo on May 24, '08
  11. Visit  LaRN} profile page
    0
    Quote from dijmart
    I've been doing home health for 4 mos. and it's really been a roller coaster ride trying to figure out what clients want or expect from me.....
    Yes, 60% act as if I "demanded" to come into their homes, ask personal questions and "waste" their time....Totally ridiculous!!!

    Don't get me wrong there are alot of plus's to home health and that's why I'm still doing it, but I wish the patients understood we are their advocates and are trying to help them NOT be a nuisence to their lives. If I see something that isn't right I call the doctor- Only to be told later by the pt that I should've minded my own business, because now they have to take a medication they can't afford, ect...I could go on and on w/ these examples!.....So, end result they get mad at me for advocating for them and sometimes even request that I don't come back......Sometime I think I care too much and that I get too involved w/ each patients case BUT isn't that are job
    I hear you on this one. Things like this were so commonplace, it got to the point if I noted a problem that needed intervention I would say to the patient "look you got a problem, and it's YOUR business, but it's MY business to tell you about YOUR business, I can stop if you wish, but I have to inform you of it."
  12. Visit  DDRN4me} profile page
    1
    what i have found is that these folks are frightened of losing their independance and of having a "stranger" let into their homes to provide quite intimate care.
    I usually explain at the onset of the intake meeting that I will be asking a lot of questions and that this one visit will take some time but the rest of the visits will be shorter and more focused on them. I also schedule a second visit in a short time to seal that deal.
    My 99 yo GM was resistant to HHAs at first; she felt that they would be looking to put her in an LTC... so its often the fear of what you will say and do that causes them to be so oppostiional. ...and sometimes they are just plain ornery
    kaliRN likes this.
  13. Visit  Buck.RN} profile page
    0
    Hi,
    I haven't participated in forums before so please bear with me. I have been nursing for about 20 yrs, more than 15 in HH accumulatively. Sure, some people resent our service but most of my experience has been very positive.
    I almost always seem to be able to establish a common ground with my patients....I'm married, a granddad, a vet, used to be a carpenter, bus driver, cook, you get the picture. I look for family pictures, ask a few questions about them, find out what my patient did for a living, grouse about the weather, talk about my wife's flower beds, anything that breaks the ice. It doesn't take long, usually as long as it takes to get all my paperwork lined up, the patient to get insurance cards out, that sort of thing. It usually works. When I do get a sour pus I suck it up, try to keep it light, get done and get on. Keep trying. There really is no better nursing niche than HH despite the HA's.
  14. Visit  Asands} profile page
    0
    One of the worse experiences I had was when I was falling in for another nurse. I didnt know my patient had dementia and I came in and she didnt look at me and had her eyes glued to the tv. I introduced myself and she pushed my hand away. I go quietly in the kitchen to look at reports. Ahhhhh i see she has dementia well that explains it. Then I had to check her bloodsugars. The only pen she has is a pen ive never used before. There are no directions anywhere about how to use the lancet pen. So I go to her and try to use the pen, lancet doesnt work. She gets so angry at me and calls me incompetent etc etc. I felt mortified. I had to look up how to use this specific pen on internet and i got it right the next time but it was defintly an embarassing moment...
  15. Visit  nursynurseRN} profile page
    0
    I have been doing part time HH for the better part of this year plus my hospital 12 hr shifts to compensate the difference. I really like the flexibility of HH and the extra time I have with my family. Even if it is just at home sitting on th couch charting with the baby. When I work in th hospital I feel more in command because the patient is in my territory. What I say usually goes and if they don't want anything I just chart "refused". In home health it seems like many patients don't want us there. They feel like we are a nuisance in there homes. This Is one of the worst parts of HH I think. There are more pros then cons I think and even on 12 hr shift I think there are a lot of pros and cons.


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